C. NEOFORMANS CRYPTOCOCCOSIS

C. neoformans Cryptococcosis develops when a person breathes in the microscopic fungus found in soil or rotting wood infected with bird droppings, particularly pigeon droppings. Interaction with an infected person could also help transmit the virus. C. neoformans is the most frequent cryptococcosis infection. The likelihood of developing cryptococcosis is higher in patients who have received high doses of corticosteroids, organ transplant patients, cancer patients taking chemotherapy, and those with AIDS or HIV infection. Due to the worldwide spread of AIDS, cryptococcosis is currently one of the most prevalent life-threatening fungal diseases in these individuals.

Furthermore, C. neoformans Cryptococcosis is prevalent in both people and animals, although neither animal-to-human nor human-to-human transmission by respiratory droplets has been observed. There have been reports of transmission during organ transplantation when contaminated donor organs were used. Infection from incisions in the skin is uncommon but possible.

SYMPTOMS

Though C. neoformans may infect other organs, it is most often observed in the lungs or the brain. The symptoms of the infection differ according to the body sections involved.

In the lungs

Infection with C.neoformans in the lungs may result in a pneumonia-like disease. Among the symptoms are:

  • Cough
  • Chest pain
  • Shortness of breath
  • Fever

In the brain (cryptococcal meningitis)

After spreading from the lungs to the brain, C. neoformans and other varieties of Cryptococcus cause an infection known as cryptococcal meningitis. The signs and symptoms of cryptococcal meningitis:

  • Fever
  • Neck pain
  • Confusion or changes in behavior
  • Nausea and vomiting
  • Headache
  • Sensitivity to light

DIAGNOSIS

To aid in the diagnosis of cryptococcal illness, the following laboratory and radiological tests are done.

  • Fixed-tissue specimen staining
  • Serum  testing for cryptococcal antigen
  • Culture of blood, sputum, and CSF

Clinical signs of an indolent illness in immunocompetent people and a more severe, progressing infection in immunocompromised patients point to a diagnosis of cryptococcosis. Urine collection, a lumbar puncture, and a chest x-ray are performed first.

TREATMENT

Individuals with C. neoformans infection must take prescription antifungal treatment for at least six months and frequently longer. The degree of the infection and the areas of the body that are affected typically determine the type of treatment.

  • Cryptococcal meningitis is treated with amphotericin B with or without flucytosine, and then fluconazole is given.
  • Nonmeningeal cryptococcosis is treated with fluconazole. 

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